AMDA Foundation - LTC-QI Partnership Meeting: Progress Apparent Despite Challenges and Bad Weather

Home

Vol XVII, Aug `05

LTC-QI Partnership Meeting: Progress Apparent Despite Challenges and Bad Weather

Vol XVII, Aug `05

During a recent meeting of the National Long Term Care Quality Coalition, leaders and stakeholders in the AMDA Foundation-Long Term Care Quality Improvement Partnership study funded by the Agency for Healthcare Research and Quality (AHRQ) addressed the barriers to facility recruitment, data collection challenges, and lessons learned as the research project progresses. David Polakoff, MD, CMD, the study's principal investigator, talked about how an early AMDA Foundation goal was to examine the implementation of AMDA clinical practice guidelines and their impact on quality care. This goal was realized through this four-year AHRQ grant.

The group had decided early on to focus on six states, with 10 participating facilities in each. The facilities would be randomized to use one of two guidelines--pressure ulcers and pain management. "We had an inkling that quality improvement organizations would focus on these two areas, and we thought that they would be high priorities for facilities," Polakoff explained. Although each facility will use only one CPG, data will be collected for both areas.

Among the first challenges was finding good state nurse coordinators in the pilot states and getting these individuals up and running. These nurses then faced the difficult task of recruiting facilities. "How do you create a sense of urgency in facilities and get them to share the enthusiasm we have for this project?" Pennsylvania Nurse Coordinator Marcia Yesko asked. Another challenge was that the exclusion criteria eliminated many facilities from participation. The project leaders expanded the criteria a little--enough to make more facilities eligible but not to affect the quality of the data. This helped bring in a few more study sites.

Pennsylvania eventually recruited five facilities and just began its nine-month data collection. Of course, data collection presents a whole new set of challenges (e.g., consistent follow-up, reliable collection, following instructions). Yesko and the other state nurse coordinators will stay on top of these issues to ensure that data is accurate and reliable.

CLICK HERE to read more about the LTC Quality Coalition meeting and recruitment experiences in other states.